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Dysphagia, regurgitation and weight loss in an elderly man

Laura Lamprell and David Wright
Med J Aust 2014; 201 (2): 114. || doi: 10.5694/mja14.00269
Published online: 21 July 2014

An 84-year-old man reported unintentional weight loss of 15 kg over 18 months and dysphagia and regurgitation of undigested food over 3 months. Barium swallow showed a large pharyngo-oesophageal (Zenker) diverticulum. These are caused by elevated intraluminal pressure at the Killian dehiscence, an area of hypopharyngeal weakness between the cricopharyngeus and inferior pharyngeal constrictors.

Zenker diverticula are rare, but can cause significant morbidity and mortality. A barium swallow should precede gastroscopy, as there is a risk of perforation and mediastinitis. We performed endoscopic stapling, as it is less invasive than open repair.

  • Laura Lamprell
  • David Wright

  • Otolaryngology Head and Neck Surgery, The Townsville Hospital, Townsville, QLD.

Correspondence: laura.lamprell@gmail.com

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